Out of the Box

Phuket Marine Biological Centre begins research to understand appearance of box jellyfish along Thailand's coast by Eric Haeg

Among dangerous creatures in the ocean, box jellyfish rank high as one of the most venomous. Thankfully, the creatures mostly inhabit specific pockets around the world, notably the north coast of Australia. Recently, however, box jellyfish, whose sting can sometimes kill humans in minutes, have turned up in the waters off of Thailand’s coast.

The antidote to the sting from a box jellyfish is simple vinegar, and one Australian man who had a near-fatal brush with a box jellyfish in the Gulf of Thailand is leading a charge to raise public awareness. Last December, Andrew Jones’ 6-year-old son, Lewis, was stung while swimming off of Koh Maak island, which neighbours Koh Chang. Not knowing treatment procedures, Jones peeled the gelatinous tentacles from his son’s legs only to get stung himself. Soon Lewis’ screams of agony subsided; his face turned blue, and his heart stopped pumping for two minutes. Miraculously, Lewis survived.

Since then, Jones has contacted experts in the field, embassies, guidebook publishers, government officials and news agencies in an effort to increase public awareness. Box jellyfish are “lurking in (Thailand’s) waters, and someone has to take responsibility before more people die,” he says.

Locally, marine researchers have listened to Jones’ pleas, launching a study of box jellyfish and their presence in the waters of coastal Thailand. Dr. Somchai Bussarawit, lead researcher at the Phuket Marine Biological Centre (PMBC), recently collected samples of box jellyfish off the coast of Koh Lanta. The research project started only a few months ago, and Khun Somchai and PMBC Director Wannakiat Thubthimsang note that they have much to learn about box jellyfish. From the evidence so far, however, they don’t consider the it to present a significant danger in Thailand.

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First aid

If swimming at a beach where box jellies are known to be present, a bottle of vinegar is an extremely useful addition to the first aid kit. Following a sting, vinegar should be applied for a minimum of 30 seconds. Acetic acid, found in vinegar, disables the box jelly's nematocysts that have not yet discharged into the bloodstream (though it will not alleviate the pain). Vinegar may also be applied to adherent tentacles, which should then be removed immediately; this should be done with the use of a towel or glove to avoid bringing the tentacles into further contact with the skin. These tentacles will still sting if separate from the bell, or if the creature is dead. Removing the tentacles without first applying vinegar may cause unfired nematocysts to come into contact with the skin and fire, resulting in a greater degree of envenomation. If no vinegar is available, a heat pack has been proven for moderate pain relief. However, careful removal of the tentacles by hand is recommended.Vinegar has helped save dozens of lives on Australian beaches. Although commonly recommended in folklore and even some papers on sting treatment, there is no scientific evidence that urine, ammonia, meat tenderizer, sodium bicarbonate, boric acid, lemon juice, freshwater, steroid cream, alcohol, cold packs or papaya will disable further stinging, and these substances may even hasten the release of venom. Pressure immobilization bandages, methylated spirits, or vodka should never be used for jelly stings. Often in severe Chironex fleckeri stings cardiac arrest occurs quickly, so Cardiopulmonary resuscitation (CPR) can be life saving and takes priority over all other treatment options (including application of vinegar). Activate the emergency medical system for immediate transport to the hospital.